OVERVIEW

What is cerebral palsy in children?

Cerebral palsy in children refers to a group of permanent movement disorders that appear during infancy or early childhood, affecting mobility and balance.

Symptoms and severity vary among individuals. Common symptoms include poor muscle coordination, stiffness, weakness, difficulty swallowing or speaking, tremors, as well as sensory impairments such as touch, vision, or hearing issues. Infants with cerebral palsy often lag behind their peers in milestones like rolling over, sitting, crawling, or walking.

Treatment primarily focuses on enhancing social and emotional development, communication, education, nutrition, mobility, and maximizing independence in daily life.

Additionally, parents may experience shame, guilt, or emotional distress due to their child’s condition. It’s crucial for parents to stay confident and seek early medical intervention. Family and friends should offer understanding and support, treating them without prejudice and respecting their privacy.

The primary symptoms of cerebral palsy generally do not worsen with age, and most affected children can live into adulthood. However, those with extensive brain damage, immobility, lack of toileting skills, or dependence on feeding tubes have lower survival rates.

How common is cerebral palsy in children?

The prevalence of cerebral palsy is approximately 2 cases per 1,000 children. The risk is significantly higher in premature infants with low birth weight.

SYMPTOMS

What are the common manifestations of cerebral palsy in children?

The symptoms of cerebral palsy in children can range from mild to severe, primarily presenting as abnormalities in movement and posture, with varying manifestations at different ages.

During infancy, symptoms may include abnormal neurobehavior (such as excessive docility or irritability), abnormal muscle tone, abnormal posture, failure of primitive reflexes to disappear as expected, and inability to reach motor developmental milestones for their age.

In childhood, the manifestations differ depending on the type of cerebral palsy.

How many types of cerebral palsy in children can be classified?

It can be divided into five categories, including:

• Spastic type: Stiff muscles that impair movement.
• Dyskinetic type: Inability to control muscle coordination, making it difficult to perform stable or regular movements.
• Tremor type: Body tremors, with poor balance and coordination.
• Hypotonic type: The opposite of the spastic type, characterized by weak muscles, frequent falls while walking, and even difficulty lifting the head.
• Mixed type: A combination of the above types.

Besides movement and posture abnormalities, what other issues may accompany cerebral palsy in children?

Many children with cerebral palsy also experience other problems, including:

• Difficulty drinking or eating, which can lead to issues such as insufficient weight gain and choking.
• Acid reflux, where stomach acid flows back into the esophagus, causing a burning sensation in the throat or chest, abdominal pain, nausea, or vomiting.
• Lung infections.
• Learning and cognitive difficulties.
• Hearing, speech, and vision problems, with many children exhibiting strabismus (crossed or wandering eyes).
• Seizures, which involve abnormal electrical activity in the brain, leading to tremors, stiffness, brief unresponsiveness, staring spells, or fainting.
• Spinal curvature (scoliosis).
• Bladder control issues and constipation (infrequent bowel movements).
• Hip dislocation.
• Pain, often associated with muscle stiffness, hip problems, or constipation.

What severe consequences can cerebral palsy in children cause?

Studies show that children who cannot move, lack toilet skills, and require feeding tubes often die before the age of 5, with only 20% surviving to age 10. Respiratory diseases (typically aspiration pneumonia) are the most common cause of death.

CAUSES

What are the causes of cerebral palsy in children?

There are many causes of cerebral palsy in children.

• Most cases are believed to be caused by prenatal factors, including premature birth, low birth weight, acute hypoxia during delivery, intrauterine growth restriction, intrauterine infection, prenatal bleeding, severe pathological placenta, multiple pregnancies, genetic factors, as well as maternal alcohol abuse, maternal smoking, and infections during pregnancy.
• Postnatal causes of cerebral palsy in children include trauma, severe hypoxic events, sepsis or meningitis, stroke, kernicterus, etc.

Is cerebral palsy in children contagious?

No.

Is cerebral palsy in children hereditary?

Some causes of cerebral palsy are related to genetics.

DIAGNOSIS

How is cerebral palsy diagnosed in children?

The diagnosis of cerebral palsy is based on a series of clinical findings, including delayed motor development, persistent primitive reflexes, and abnormal postural responses. There is no specific test to confirm the diagnosis of cerebral palsy.

For most children, the diagnosis of cerebral palsy is made within the first 2 years after birth, but it may be delayed in children with mild symptoms.

What tests are needed to diagnose cerebral palsy in children?

Through physical examination and symptom assessment, doctors can generally determine whether a child has cerebral palsy. However, due to variations in developmental rates during the first 2 years of life, a definitive diagnosis is not always possible. Additional diagnostic tests for suspected cerebral palsy cases include:

• Magnetic Resonance Imaging (MRI): This imaging test provides detailed images of the brain, helping identify structural abnormalities. It may assist in determining the cause and prognosis of cerebral palsy but cannot definitively confirm or rule out the diagnosis.
• Electroencephalogram (EEG): This test measures electrical activity in the brain and records brainwave patterns. It helps determine whether epilepsy is present and guides treatment. It may be performed if seizures are suspected.
• Other tests: In some cases, doctors may recommend lumbar puncture, metabolic and genetic testing, or thrombophilia screening to identify the underlying cause and aid in diagnosis.

What conditions are easily confused with cerebral palsy in children, and how can they be distinguished?

• Muscle weakness (myopathy): Cerebral palsy is often confused with muscle weakness. Generally, in children with cerebral palsy, the degree of hypotonia (low muscle tone) is equal to or greater than muscle weakness, whereas in myopathy, muscle weakness is more pronounced.
• Spastic diplegia or quadriplegia: Cerebral palsy may be confused with spasticity caused by urea cycle disorders, leukodystrophy, or other neurodegenerative diseases. These conditions can be distinguished by disease progression and metabolic or genetic testing.
• Dystonia and choreoathetosis: Cerebral palsy may resemble dystonia and choreoathetosis, which are prominent features of various genetic and metabolic syndromes. Acquired causes include acute rheumatic fever, cardiac bypass surgery, and kernicterus.

TREATMENT

Which department should I visit for pediatric cerebral palsy?

Pediatrics, Pediatric Neurology, Rehabilitation Medicine.

Can pediatric cerebral palsy heal on its own?

Pediatric cerebral palsy is a permanent movement disorder that lasts a lifetime and cannot resolve on its own.

What are the treatment goals for pediatric cerebral palsy?

To help the child achieve maximum independence, promote social and emotional development, ensure proper nutrition, and enable the child to benefit from education.

How is pediatric cerebral palsy treated?

Treatment mainly includes:

• Physical training: A crucial part of treatment, aimed at teaching parents how to assist the child with daily activities (such as eating, speaking, walking, and learning) and improving the child's ability to move, live, and work independently, especially hand function. Training should begin early and continue at home. Common methods include bimanual training and constraining the unaffected limb to encourage use of the affected one.
• Medication: Helps manage symptoms like muscle stiffness, abnormal movements, or seizures.
• Assistive devices: Includes leg braces, walkers, or wheelchairs to aid mobility.
• Nutritional support: Some children require special diets or feeding tubes (e.g., gastrostomy tubes) to maintain adequate weight and health.
• Surgical correction: For severe cases, surgery may be needed to correct limb positioning.

Does pediatric cerebral palsy require hospitalization?

Mild cases usually do not, but hospitalization may be necessary for complications like infections due to choking or surgical needs. The decision depends on the doctor's assessment.

What are the common side effects of medications for pediatric cerebral palsy?

Botulinum toxin, used to treat spasticity, is the main medication. Side effects are typically mild and temporary, including fever (lasting 1–3 days), pain, local irritation, and bruising. Rarely, temporary weakness or incontinence may occur. Long-term use may reduce effectiveness over time. Treatment duration is determined by the doctor.

Can pediatric cerebral palsy be completely cured?

No, it is a lifelong condition, but treatment can significantly improve the child's quality of life.

DIET & LIFESTYLE

What should children with cerebral palsy pay attention to in their diet?

Food choices should be nutritious, easy to digest, and absorb. Include lean meat, dairy products, eggs, liver, fresh fruits, and vegetables.

What should children with cerebral palsy pay attention to in daily life?

Most children with cerebral palsy have motor impairments, increased muscle tone, and varying degrees of abnormal posture. Limited interaction with the outside world can easily lead to feelings of inferiority and loneliness, manifesting as low self-confidence. Therefore, parents should spend more time with the child, strengthen physical communication, and encourage active movement and interaction.

Additionally, it is important to position the child properly during meals to prevent increased muscle tone, avoiding unnecessary involuntary movements and abnormal postures.

Can children with cerebral palsy survive long-term?

Children with mild cerebral palsy often live as long as healthy individuals. Those with more severe cases may not survive as long. Special equipment and techniques can help children move and learn as much as possible.

Do children with cerebral palsy need follow-up examinations? How?

Follow-up examinations are necessary to assess treatment effectiveness, with the frequency determined by the doctor.

How should family members care for a child with cerebral palsy?

Social and psychological support is crucial for families of children with cerebral palsy. Parents may experience prolonged grief, guilt, frustration, denial, anger, resentment, or embarrassment, which may lead to social withdrawal or strained family relationships. We should show understanding, avoid discrimination, and offer appropriate assistance.

PREVENTION

Can cerebral palsy in children be prevented? How to prevent it?

Possible preventive measures include expectant mothers undergoing prenatal check-ups, avoiding unhealthy habits during pregnancy, conducting regular developmental assessments and physical examinations after the child is born, and seeking timely medical treatment if the child falls ill.